Basic Information
| Provider Information | |||||||||
| NPI: | 1306873476 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEWSOME | ||||||||
| FirstName: | BRITT | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 RAMPART WAY # WAU | ||||||||
| Address2: | SUITE 300B | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802306440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033274700 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 130 RAMPART WAY # WAU | ||||||||
| Address2: | SUITE 300B | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802306440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033274700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 04/22/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 24449 | AL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | 47191 | CO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 009936887 | 05 | AL | MEDICAID | 009936888 | 05 | AL | MEDICAID | 51578069 | 05 | CO | MEDICAID |